Short OSCE

Now here comes the Short OSCE for our batch.We have 10 stations for it,5 minutes for each station (which is quite short and we have to rush!)

1.Patient just had a bowel surgery.Perform a focused abdominal examination and examiner will ask you a few questions.
-Basically this is a Stoma bag examination station.
-Patient has a end colosotomy
-We are expected to assess the stoma bag content,its complication (parastoma hearnia-ask patient to cough!)and the scars
-We are expected to look for scars in perineum
-Examiner will ask what surgery has been done-Should be abdomino perineal resection-Because it is a permanent end colostomy
-What the indication of it/causes to make a stoma bag

2.Patient has a valve replacement done.Examine the precodium of the patient.
-Patient has a prosthetic click heard (Very obvious) on first heard sound,therefore it should be Mitral valve replacement done
-What is the ideal INR for the patient?Since it is a prosthetic valve replacement,the range should be 2.5-3.5
-We are expected to perform all the maneuvers that can accentuate the murmuer (ask the patient to left lateral,hold breath,ask patient to lean forward

3.Patient has blurring of vision.Perform a confrontation test on this patient and examiner will ask you a few question
-Patient has homonymous hemianopia
-Remember to explain properly what you are going to do! (Test patient vision by moving pen in front of him first,then explain to him(fix the head,look at your eyes)).
-What other test you can do to confirm your diagnosis (Use the red tip pen to perform the same test again)
-Examiner ask you the diagnosis and where is the lesion (occipital lobe and optic radial nerve)

3 questions for now,will be continued..